Nailfold Capillaroscopy Findings in Rheumatoid Arthritis Patients and its Correlation to Teatment Response | ||
| Ain Shams Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 19 November 2025 PDF (525.97 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asmj.2025.374110.1432 | ||
| Authors | ||
| Omnia Abubakr1; Rasha Mahmoud1; amira El Mahdi* 2; Samia Mohamed Rashad3 | ||
| 1Ain Shams | ||
| 2Ain Shams unveristy | ||
| 3Ain Shams Univercity | ||
| Abstract | ||
| Background: Nailfold capillaroscopy (NFC) is a non-invasive method to assess microvascular change. Aim: Evaluate NFC abnormalities in RA patients and assess the correlation between NFC findings and therapeutic responses in patients receiving biologics versus conventional synthetic DMARDs (csDMARDs). Methods: In this prospective study, 76 RA patients were divided into two groups: Group I (biologics) and Group II (csDMARDs). Capillaroscopic parameters, disease activity scores (DAS-28), and laboratory markers were assessed at baseline and after 6 months. NFC findings, including capillary number, width, length, shape abnormalities, and density scores, were analyzed before and after treatment. Results: At baseline, both groups demonstrated common NFC abnormalities, such as tortuous, meandering, dilated capillaries and avascular areas. Tortuous capillaries were observed in 100%), meandering capillaries (34.2%), and dilated capillaries (25%) while microhemorrhages were rare (2.6%). Sub-papillary venous plexus (SPVP) visibility and normal U-shaped architecture were uncommon (11.8% and 19.7%, respectively). After 6 months, significant improvements in capillary number and width were reported, particularly in Group I. Group I demonstrated a greater reduction in capillary width (p<0.001).In Group I, etanercept led to the most significant increase in capillary number, while Baricitinib resulted in the lowest capillary width. Conclusion: NFC effectively assesses microvascular involvement and monitors therapeutic response in RA. At baseline, RA patients commonly exhibited NFC findings such as tortuous, meandering, and dilated capillaries. Biologic therapies showed greater improvement in capillary parameters compared to csDMARDs. NFC may aid in selecting the most appropriate therapy, particularly in cases with significant microvascular involvement. | ||
| Keywords | ||
| Biologics; csDMARDs; nailfold capillaroscopy; rheumatoid arthritis | ||
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